FEMALE RHINOPLASTY*

Examples of some of Dr. Scaccia’s surgical results. All photos are untouched and shown with patient’s permission.
Disclaimer: Results may vary*

Female Rhinoplasty*

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A young lady with before and after photos demonstrating correction of nasal deformity that resulted from both trauma to the nose and underlying congenital aesthetic issues. As can be seen in the preoperative picture, the patient had a prominent dorsal bony cartilaginous hump and deviation of the bony cartilaginous dorsum to her left. She also had somewhat of a wide bulbous tip that was ill-defined. In the after pictures, you can notice that the nose is now midline, the bony cartilaginous hump has been corrected to a more aesthetically pleasing feminine profile and her nasal tip has been narrowed, slightly lifted and defined. A cartilaginous tip graft harvested from her septum was utilized to help provide more support and structure to her tip. In addition, her breathing was improved with a septoplasty and partial turbinectomy. The patient is only six weeks postop and will continue to improve as swelling subsides.

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Female Rhinoplasty*

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Before and after photos of a young lady who underwent a correction rhinoplasty and chin augmentation. The patient was also unhappy with her breathing and sinuses and that was corrected at the same time with a very successful outcome. As can be noted on the preoperative exam, especially on the anterior view, you can notice that she had somewhat of a small chin and her face was out of proportion with the lower third of her face being not harmonious with the dimensions of her upper and middle third of her face. Also, the lateral view depicts a weak chin that was mildly behind the ideal projection line which is up to the vermilion border of the lower lip. Her nose had a small dorsal cartilaginous bony hump and bulbosity. She was happy with the angle of her tip and desired to have only minimal elevation of the nasal tip. It was thought that her rhinoplasty would result in greater than desired rotation of her tip upwards unless a septal cartilage tip graft was placed at the end to counteract this. This was done during the surgery which added a slight amount of bulbosity to the tip but yet prevented her from being rotated excessively in the postoperative period. She was very happy with the result. As you can see in the postoperative results, her nose has a more elegant feminine dorsal appearance. The tip is not excessively rotated. It is still somewhat swollen at two months and should continue to improve and now she has harmonious balance between the lower portion of her face, chin/mandible area in relation to her mid-face and forehead because of the chin implant that was placed.

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Female Rhinoplasty*

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Pre and postoperative views of a young lady who underwent a correction rhinoplasty for a mildly crooked nose with a small, subtle bony cartilaginous hump. As can be seen in the postoperative views taken at three weeks, her nose appears much more symmetrical and straight in the frontal shots and three-quarters view. The bony cartilaginous prominence noted in the mid portion of the dorsum of her nose is now smooth and straight. Lateral side shots demonstrate a conservative correction of the bony cartilaginous hump. This was all done using an open rhinoplasty approach to help obtain the narrowing and subtle corrections that were necessary to improve the appearance of her nose. In addition, the patient obtained improvement in her breathing from a septoplasty and turbinectomy that was done at the same time.

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Female Rhinoplasty*

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Three month postoperative view of a young lady who underwent correction rhinoplasty.
As can be seen in the postoperative pictures, a small bony cartilaginous dorsal hump was corrected to help soften and feminize her profile. Her tip was modestly debulked and narrowed.
A double tip graft utilizing her septal cartilage was also used to add definition to the end of the tip and to prevent any unwanted upward rotation at the tip as preoperatively she already had some pre-existing upward tip rotation. The placement of the tip grafts was to prevent any further rotation during the surgical tip maneuvers. The patient was also quite pleased not only with her aesthetic result but her functional ability to breathe much easier as a septoplasty was done to straighten out her septum and partial turbinectomies were done to correct the size of her turbinates.

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Female Rhinoplasty*

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Very early eight day postoperative view (immediately after cast correction in the office) of a young lady who underwent correction rhinoplasty. As can be seen on the lateral view, the patient presented with a very large dorsal bony and cartilaginous hump which was successfully corrected. She also had a high nasal frontal angle which was corrected, although there is still some evidence of swelling in that area postoperatively. Excessive caudal septal show which resulted in slightly enlarged nostrils was corrected as can be seen on the lateral view also. The frontal view demonstrates a more narrowed and defined tip that is mildly lifted into a more aesthetically pleasing fashion. Her nose also appears straighter. The bifidity between her tip domes has been corrected and her nasal obstruction has been corrected and her breathing has improved.
After eight days, she has minimal bruising around the eyes and nose due to a meticulous technique. Residual swelling has resolved after two months.

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Female Rhinoplasty*

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Three month postoperative views of a teenager who underwent correction rhinoplasty. As depicted in her postoperative pictures, surgery included correction of a bony cartilaginous hump, elevation and narrowing of her bulbous tip elevation and narrowing of the nostrils. The procedure was done via an open rhinoplasty approach where her lower lateral cartilages were trimmed and multiple suture techniques, including a spanning suture, were used to help narrow her strong bulbous tip. Because her nostrils still flared at the end of the procedure, modified Weir excisions were done to narrow the base of her nose. A slight prominence was left on the dorsum of her nose to balance out her strong chin. In addition, a septoplasty and turbinectomy were done to improve her breathing. Her nose is now more elegant and appropriate for her face and although a significant amount of work was done, she still maintains a very natural appearance.

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Female Rhinoplasty*

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Early five week postoperative result of celebrity reality star, Amy Fisher, who underwent a revision rhinoplasty. Amy had her original nasal surgery many years ago by another surgeon and was never happy with the appearance of her nose and breathing. It was determined that her nasal functional obstruction was due to a combination of enlarged hypertrophic turbinates and some collapse of her external nasal valve due to over-resection of her tip cartilages from the previous surgery. Because she did not have adequate septal cartilage available due to her prior surgery, her own ear cartilage was harvested so that it could be used in the reconstruction. An open rhinoplasty approach was used so that a more accurate assessment and treatment could be used. She was noted preoperatively, as can be seen on her frontal view, to have collapse and pinching of her alar tip, retraction of her nostril rims and a noticeable bossae of her right tip cartilage. This was causing asymmetry of her tip with an outward prominence and irregularity of her tip. This was corrected by correcting the distorted and abnormally shaped underlying tip cartilages and replacing them with strategically shaped ear cartilage grafts that were used both along the alar sidewall and as tip grafts. As can be seen in the postoperative view, the tip is now more symmetric and straight, although there is still some swelling which has subsided as can be seen in her one year professional picture above. On the three-quarter views, her preoperative depressions and irregularities of her tip are now corrected and replaced with a much smoother and natural contour. Postoperative views demonstrate a more symmetric and natural tip and nostrils with only slight evidence of the open rhinoplasty incisional scar which is all but invisible at this time.

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Female Rhinoplasty*

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Very early three week postoperative view of a young lady who underwent a cosmetic rhinoplasty and septoplasty and turbinectomy for breathing issues. As can be seen in the frontal view, her nose preoperatively was twisted to the right with an over-projected hanging tip that was corrected via an open rhinoplasty approach to a transcolumellar incision that can be seen in the submental worm’s-eye view and the inverted-V scar is seen to be healing quite well and almost imperceptible even at the three week period. She also underwent a left Weir nostril narrowing because of asymmetric nostrils. That scar will also continue to heal in the months ahead. As can be seen in the postoperative view, her tip is lifted to a more elegant retro-displaced position and also narrowed and debulked. Despite thin skin, the highlights of her tip appear well defined and symmetric. Lateral views postoperatively demonstrate a shortening of her caudal septum that resulted in less nostril show and also correction of her bony and cartilaginous dorsal hump producing a more aesthetically pleasing and feminine profile. Osteotomies were done to help narrow the nose. Swelling is still obvious along the sides of her nose. As the swelling subsides, the nose will appear more narrowed as she continues to heal.

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Female Rhinoplasty*

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This case demonstrates the ten week postoperative result of a young lady who underwent a correction rhinoplasty and a septoplasty and turbinectomy for nasal obstruction. As can be seen from the frontal view, the patient presented with somewhat of a bulbous, ptotic, hanging tip. Her skin was thick which obscured definitions of her tip cartilages. Side view demonstrated again a weak, ptotic tip that was crowding her upper lip with an obvious bony cartilaginous nasal hump.
She also had asymmetric increased lateral spread of the width of her nostrils, more prominent on the left. The patient underwent a correction rhinoplasty via the open approach with correction of the bony hump, placement of a tip graft to allow for more definition, rotation of the tip in a more upward aesthetically pleasing position along with the use of a spanning suture to help obtain maximum narrowing of the tip as can be seen in the worm’s-eye basal view. The nose is now more narrowed and defined and elegant in appearance and will continue to improve as the swelling subsides over the next few months.

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Female Rhinoplasty*

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Very early 17 day postoperative pictures of a young lady who underwent correction rhinoplasty.
As can be seen in the preoperative pictures, the patient had a significant deviation of her nasal dorsum to the left probably secondary to previous trauma. In addition, she had a very prominent bony and cartilaginous dorsal hump and over-projected nose with excessive caudal septal show and crowding of the upper lip. As can be seen in the postoperative pictures, although there still is significant swelling, she now has a more straight symmetric and aesthetically pleasing nose. The dorsal hump has now been corrected to a nice feminine profile slope. Her caudal septum although still somewhat swollen has been shortened, the tip has been brought back closer to her face and narrowed. Osteotomies were only done on the left side of the nose as that was all that was needed to straighten and help narrow the nose. Her breathing was also significantly improved with a septoplasty and turbinectomy. The tip and dorsum of the nose will continue to improve and narrow as swelling subsides over the ensuing months.

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Female Rhinoplasty*

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Two month postoperative view of a young lady who underwent reconstructive correction rhinoplasty. As can be seen in the after pictures, the patient underwent subtle significant improvement in both narrowing of her bulbous tip and correction of her prominent bony and cartilaginous dorsum. Also note in the subnasally worm’s-eye view the shape of her boxy tip was converted from a square type shape to a more pleasing trapezoidal triangular shape. Her nostrils are also more symmetric. The open rhinoplasty scar is still slightly visible but healing nicely. Also notice that her tip on the lateral view has been slightly rotated in a more upward fashion for a more feminine, elegant appearance. Further refinements will become obvious as the swelling continues to subside. In addition, her breathing has been substantially improved as she also underwent simultaneously a septoplasty and turbinectomy.

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Female Rhinoplasty*

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Three month postoperative views of a patient who underwent open rhinoplasty to correct multiple congenital nasal deformities. As can be seen on the preoperative views, the patient exhibited somewhat of a hypoplastic twisted tip to the right. In addition, her tip was somewhat bulbous and rotated up and she demonstrated a moderately sized cartilaginous and bony hump. Postoperatively, we successfully corrected her hump to a more aesthetically pleasing feminine profile. In addition, we narrowed her bulbous tip and prevented any further upward rotation by placing double cartilaginous tip grafts at the end of the nose. The cartilage was harvested from her deviated septum during the septoplasty that was done initially to improve her breathing. Also note the vascular telangiectasia vessel that can be seen preoperatively on the inferior margin of her left nostril which is seen in the three-quarter oblique view that is now gone after obliterating it with the radio surgical device during the procedure. Also notice the three pigmented lesions on her forehead, cheek and chin that were also corrected using a sutureless radio surgical ablation technique.

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Female Rhinoplasty*

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Nine month postoperative views of a young lady who underwent correction rhinoplasty. Preoperatively, the patient demonstrates mild bulbosity to her tip and a small bump/prominence to the dorsum of her nose. Because the patient’s preoperative nose only exhibited mild deformities, the surgery only required subtle changes. Anything too dramatic would have resulted in an overdone, unnatural look. As can be seen in the nine month postoperative view, her tip is now more narrowed and defined and the bony cartilaginous hump on profile and three-quarter view has been corrected to a more feminine, aesthetically pleasing profile height.

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Female Rhinoplasty*

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Eight month postoperative result of a young lady who underwent correction rhinoplasty.
As can be seen in the postoperative changes, only subtle refinement was necessary in order to preserve the natural beauty of her face and to improve on the aesthetic contours of her nose.
A small hump was corrected. The nasal bridge and tip were narrowed, both of which can be appreciated on the lateral view and three-quarter view. In addition, hypertrophic inferior turbinates and a deviated septum were corrected to improve her breathing.

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Female Rhinoplasty*

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Two month postoperative views of a young lady who underwent correction rhinoplasty. As can be seen in her preoperative pictures, the patient presented with a bulbous wide tip and over-projected nose. She also had excessive caudal nostril show obvious on the lateral view. Retrodisplacement of the tip along with debulking of the tip and a modest hump correction allowed for a more refined and aesthetically appealing nose.

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